Child diarrhoea and nutritional status in rural Rwanda: a cross‐sectional study to explore contributing environmental and demographic factors

Abstract

Abstractobjective To explore associations of environmental and demographic factors with diarrhoea and nutritional status among children in Rusizi district, Rwanda.methods We obtained cross-sectional data from 8847 households in May-August 2013 from a baseline survey conducted for an evaluation of an integrated health intervention. We collected data on diarrhoea, water quality, and environmental and demographic factors from households with children <5, and anthropometry from children <2. We conducted log-binomial regression using diarrhoea, stunting and wasting as dependent variables.results Among children <5, 8.7% reported diarrhoea in the previous 7 days. Among children <2, stunting prevalence was 34.9% and wasting prevalence was 2.1%. Drinking water treatment (any method) was inversely associated with caregiver-reported diarrhoea in the previous 7 days (PR = 0.79, 95% CI: 0.68-0.91). Improved source of drinking water (PR = 0.80, 95% CI: 0.73-0.87), appropriate treatment of drinking water (PR = 0.88, 95% CI: 0.80-0.96), improved sanitation facility (PR = 0.90, 95% CI: 0.82-0.97), and complete structure (having walls, floor and roof) of the sanitation facility (PR = 0.65, 95% CI: 0.50-0.84) were inversely associated with stunting. None of the exposure variables were associated with wasting. A microbiological indicator of water quality was not associated with diarrhoea or stunting.conclusions Our findings suggest that in Rusizi district, appropriate treatment of drinking water may be an important factor in diarrhoea in children <5, while improved source and appropriate treatment of drinking water as well as improved type and structure of sanitation facility may be important for linear growth in children <2. We did not detect an association with water quality.

Water, sanitation and hygiene practices associated with improved height-for-age, weight-for-height and weight-for-age z-scores among under-five children in Nepal

“…However, water quality was not associated with z-score for HAZ and WAZ which indicates its effect being either neutralized for more severe forms of undernutrition or children experiencing catch-up growth with no major impact on long term nutritional health in a Nepalese context. Nevertheless, other studies have reported significant associations between water treatment practices and childhood stunting [35,44]. The discrepancies in study findings could be due to various reasons such as cultural factors that determine water handling practices [45] and effectiveness of household water purification techniques [46] that determines the quality of water and thus leading to a varying effect on nutritional outcomes.…”

Effect of community health clubs on child diarrhoea in western Rwanda: cluster-randomised controlled trial

“…We did a baseline survey of the 150 villages, which included water sampling. 8 To increase the study's power to accurately detect improvements in child health, we stratified the 150 villages along two dimensions: average fraction of children younger than 2 years with caregiver-reported diarrhoea in the previous 7 days; and average wealth index, which is a standardised variable (mean 0·04 [SD 0·67]). The wealth index is a weighted average of a household's ownership of 17 assets in three categories: durable goods such as refrigerator, television, and bicycle; large livestock such as cattle, goats, or sheep; and attributes of the housing structure, such as the roofing, wall, and floor materials.…”

Use of Serologic Responses against Enteropathogens to Assess the Impact of a Point-of-Use Water Filter: A Randomized Controlled Trial in Western Province, Rwanda

“…Diarrheal disease is a leading cause of morbidity and mortality in Rwanda, 1,2 and environmental and demographic factors contribute to both diarrhea and stunting in the country. 8 Household water treatment (HWT) appears to be effective in reducing diarrheal disease among populations with unsafe sources of drinking water. 9 Evidence of its effectiveness, however, is derived from nonblinded trials that report diarrheal disease as an outcome.…”